中、晚期肝癌介入治疗预后因素分析  

The analysis of prognostic factors in advanced hepatocellular carcinoma patients undergoing interventional treatment

作　　者：齐丽萍[1] 董志[1] 丛培生[2] 范新[1] 杨笑宏[1] 

机构地区：[1]大连医科大学附属二院放射科,辽宁大连116027 [2]大连市友谊医院影像科,辽宁大连116021

出　　处：《中国临床医学影像杂志》2002年第1期32-35,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:综合分析影响接受介入治疗肝癌患者预后的主要因素。材料和方法:采用Cox回归模型,对103例中晚期肝癌行介入治疗后进行随访,对影响预后因素进行分析。结果:总体1,2,3年生存率分别为47.57%,22.18%,14.66%。影响预后的主要因素为:包膜、肿瘤缩小率、临床分期、动静脉瘘、AFP变化、肿瘤数目、治疗方法、主瘤直径和性别。结论:对肝功良好的门脉癌栓病人应积极治疗,门脉癌栓病例可以通过化疗栓塞得到控制、治疗。化疗栓塞同时并用动脉内125I碘油内放疗,疗效优于单纯化疗栓塞,是一种很有前途的方法,值得临床推广。Objective:To evaluate the prognostic factors in unresectable HCC patients with interventional treatment.Ma -terial s and Methods:103patients with advanced HCC were treated by transcatheter arterial chemoembolization (TACE)or TACE combined with Iodine-125( 125 I).They were followed up for 6to81months.Survival time began with the time of diagnosis.Parameters likely to affect prognosis were submitted to univariate and multivariate analysis using Cox proportional hazard regression model.Result:The overall1-year,2-year and3-year survival rates were47.57%,22.18%and14.66%re-spectively.Univariate analysis showed that13prognostic factors had significantly difference.Multivariate analysis revealed the fac-tors in the regression equation were encapsulation,rate of tumor reduction,clinical stage,AVS,change of AFP value,number of tumors,method of treatment,size of main tumor and sex.Conclusion:We should take active action on patients with PV thrombus.The situation of patients with PV thrombus can be controlled and improved by using TACE when they had on se-vere liver cirrhosis and liver function impairment.TACE combined with internal radiation of 125 I was superior to simple chemoembolization.TACE combined with 125 I iodized oil was a promising method for patients with HCC and should be widely used in clinic.

关 键 词：肝肿瘤 介入性放射学 预后 介入治疗 肝癌 影响因素 

分 类 号：R735.7[医药卫生—肿瘤]